NPI Code Detail JSON Logo

1407704307 NPI number — MR. ERIC STIRGUS JR.

NPI Number: 1407704307
Health Care Provider/Practitioner: MR. ERIC STIRGUS JR.

Information about “1407704307” NPI (MR. ERIC STIRGUS JR.) exists in 1407704307 in HTML format HTML  |  1407704307 in plain Text format TXT  |  1407704307 in PDF (Portable Document Format) PDF  |  1407704307 in an XML format XML  formats.

NPI Number : 1407704307 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1407704307",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "STIRGUS",
    "FirstName": "ERIC",
    "MiddleName": null,
    "NamePrefix": "MR.",
    "NameSuffix": "JR.",
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "7326 W SILVER SPRING DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MILWAUKEE",
    "MailingAddressStateName": "WI",
    "MailingAddressPostalCode": "53218-2849",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "414-349-6170",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "4072 N 12TH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MILWAUKEE",
    "PracticeLocationAddressStateName": "WI",
    "PracticeLocationAddressPostalCode": "53209-7008",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "414-349-6170",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/18/2026",
    "LastUpdateDate": "03/18/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "322D00000X",
          "TaxonomyName": "Emotionally Disturbed Childrens' Residential Treatment Facility",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "WI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "WI",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "385H00000X",
          "TaxonomyName": "Respite Care",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "WI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "385HR2055X",
          "TaxonomyName": "Child Mental Illness Respite Care",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "WI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "320800000X",
          "TaxonomyName": "Mental Illness Community Based Residential Treatment Facility",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "WI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "320900000X",
          "TaxonomyName": "Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "WI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "385HR2060X",
          "TaxonomyName": "Child Intellectual and/or Developmental Disabilities Respite Care",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "WI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "251S00000X",
          "TaxonomyName": "Community/Behavioral Health Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "WI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "385HR2065X",
          "TaxonomyName": "Child Physical Disabilities Respite Care",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "WI",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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